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Roboterassistierte pyloruserhaltende Pankreaskopfresektion

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Robotic pylorus-preserving pancreaticoduodenectomy

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Zusammenfassung

Die pyloruserhaltende Pankreaskopfresektion ist einer der komplexesten Eingriffe in der Viszeralchirurgie. Obwohl die erste laparoskopische Pankreaskopfresektion bereits 1994 beschrieben wurde, ist die Methode bisher weltweit auf wenige Zentren limitiert. Die roboterassistierte Chirurgie mit dem DaVinci®-System kann viele Limitierungen der laparoskopischen Instrumente überwinden. Das System stellt eine vielversprechende Methode dar, minimalinvasive Eingriffe vermehrt auch Patienten mit Erkrankungen des Pankreas zu ermöglichen. Die in der Literatur angegebene perioperative Letalität liegt zwischen 0 und 5 %. Pankreasfistelraten zwischen 0 und 35 % sind beschrieben. Dem Komplikationsmanagement kommt besondere Bedeutung zu.

Im vorliegenden Video beschreiben wir die roboterassistierte, pyloruserhaltende Pankreaskopfresektion bei einer Patientin mit Karzinom der Papilla vateri.

Abstract

Pylorus-preserving pancreaticoduodenectomy is one of the most complex procedures in general surgery. Laparoscopic pancreaticoduodenectomy was initially described in 1994; however, its worldwide distribution is so far limited to only a few specialist centers. Robotic surgery using the DaVinci® system can overcome many limitations of laparoscopic surgery. The system is a promising tool for a more widespread introduction of minimally invasive surgery for pancreatic diseases. Mortality rates of 0–5% and pancreatic fistula rates of 0–35% are described in the literature; therefore, thorough complication management is crucial in the postoperative course. The video presents a robotic pylorus-preserving pancreaticoduodenectomy for periampullary carcinoma in a female patient.

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Authors and Affiliations

  1. Klinik für Allgemeine, Viszeral- Thorax-, Transplantations- und Kinderchirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland

    H. Aselmann, J. Hendrik Egberts, J. Henrik Beckmann, C. Schafmayer, S. Hinz, B. Reichert & T. Becker

  2. Intuitive Surgical Inc., Sunnyvale, CA, USA

    H. Stein

Authors
  1. H. Aselmann
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  2. J. Hendrik Egberts
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  3. J. Henrik Beckmann
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  4. H. Stein
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  5. C. Schafmayer
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  6. S. Hinz
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  7. B. Reichert
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  8. T. Becker
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Corresponding author

Correspondence to H. Aselmann.

Ethics declarations

Interessenkonflikt

H. Aselmann, J. H. Egberts sind Proctoren für das DaVinci® System. H. Stein ist bei Intuitive Surgical angestellt. J. H. Beckmann, C. Schafmayer, S. Hinz, B. Reichert und T. Becker geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Caption Electronic Supplementary Material

Zusätzliches Video 1 Roboterassistierte Pankreaskopfresektion (hohes Datenvolumen; geeignet für PCs)

Zusätzliches Video 2 Roboterassistierte Pankreaskopfresektion (geringeres Datenvolumen; geeigneter für mobile Endgeräte)

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Aselmann, H., Egberts, J.H., Beckmann, J.H. et al. Roboterassistierte pyloruserhaltende Pankreaskopfresektion. Chirurg 88, 411–421 (2017). https://doi.org/10.1007/s00104-017-0414-3

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  • DOI: https://doi.org/10.1007/s00104-017-0414-3

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